On World Polio Day 2023, Dr Rajiv Chhabra, Chief Paediatric, Artemis Hospital, Gurugram highlights the critical challenges in sustaining polio eradication
The battle against polio that is being fought globally has made significant progress in recent years. The situation seems to be ameliorating but not for every country. The World Health Organization (WHO) declared America polio-free in 1994, the Western Pacific region in 2000, and the European region in 2002. By 2019, the African region was declared polio-free, leaving only two countries, Afghanistan and Pakistan, where wild poliovirus transmission still existed. In August 2021, Africa celebrated four years without a single case of wild poliovirus, marking a significant milestone. However, as we rejoice in these achievements, it is important not to become complacent. Keeping up with polio eradication remains a monumental challenge, even in the face of apparent victory.
Resistance to vaccine
One of the biggest challenges in sustaining polio eradication is vaccine hesitancy and resistance. Despite the massive success of polio vaccines, factors like resistance to vaccines and hesitation to take vaccines continue to hinder efforts to eradicate polio. This hindrance can be removed by educating the crowd about how vaccines actually work, increasing community engagement, and creating awareness. Moreover, there are certain cultural and social restrictions as well that stand as a roadblock, hindering the progress of polio eradication. Understanding and addressing these factors is necessary to ensure that misconceptions regarding vaccines can be clarified.
Supply and quality of vaccine
Supply and quality of vaccine is another factor that needs to be given topmost priority. A well organised supply chain to ensure smooth production and distribution of the vaccine is necessary. Maintaining high vaccine quality standards is also vital. The B2B partners involved in vaccine production must ensure the production of the finest quality of vaccines.
Vaccine-Derived Polioviruses (VDPVs)
Vaccine-derived polioviruses (VDPVs) can occur when the weakened virus in the oral polio vaccine mutates and regains its ability to cause paralysis. These VDPVs are risky and sometimes cause outbreaks. Vigilant monitoring and containment is necessary to prevent these viruses from spreading.
Weak health systems
Sustaining polio eradication is based on the strength of health systems in affected countries. Weak healthcare infrastructures can restrict the reach of vaccination campaigns and hinder surveillance efforts. Strengthening health systems is necessary for not just polio eradication but also for overall public health. Moreover, many areas with ongoing polio outbreaks face the problem of conflicts and insecurity which need to be addressed.
Funding shortfalls
Financial support for polio eradication is an important issue. Lack of funds can jeopardise the implementation of vaccination campaigns, surveillance, and research. With healthcare becoming the utmost priority of many countries, securing long-term funding for polio eradication becomes challenging.
High-risk populations
Vulnerable and hard-to-reach populations, like nomadic communities, migrants, and urban slum residents, can be reservoirs of the poliovirus. Making sure that vaccination efforts reach these groups is important to preventing outbreaks.
Surveillance and data quality
Accurate and timely surveillance is necessary to detect and respond to poliovirus transmission. Maintaining high-quality data collection and analysis is vital for assessing the risk of resurgence and formulating interventions accordingly. There are several B2B entities that play a crucial role in collecting data and analysing it to track the outbreaks and responding to them as soon as possible.
Maintaining high routine immunisation coverage
While oral polio vaccine campaigns are a significant step towards polio eradication efforts, maintaining high routine immunisation coverage is equally important. Adequate coverage prevents the virus from accessing susceptible hosts, eventually leading to its extinction.
Geographical challenges
The rugged terrain in some regions, for instance the border between Afghanistan and Pakistan, makes it difficult to reach remote communities. Remote and hard to reach areas pose logistical difficulties when it comes to vaccine distribution. Overcoming geographical barriers requires innovative approaches and a well-coordinated effort.
Community engagement and trust
Sustaining polio eradication is all about trust and engagement with local communities. Healthcare workers must build relationships with communities and win their trust to ensure that children are consistently vaccinated. Keeping the people constantly engaged will also help in creating awareness and will instil a sense of responsibility in everyone regarding polio eradication.
Polio eradication is a significant achievement, but considering the prevalence of this disease in some areas, it is not the time to be complacent. The 10 challenges mentioned above explicitly show that the battle against polio is not yet over. Furthermore, sustained efforts are needed to prevent a resurgence. Vaccination campaigns, surveillance, and community engagement are critical steps in ensuring a polio-free world. As the world faces new health challenges, maintaining focus on polio eradication is necessary for global health security. Only with firm commitment and resources can we overcome these challenges and eradicate polio completely once and for all.
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